Provider Demographics
NPI:1609001353
Name:CHOI, KEYIN (MA)
Entity Type:Individual
Prefix:MS
First Name:KEYIN
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 86TH ST
Mailing Address - Street 2:APT. 2G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7512
Mailing Address - Country:US
Mailing Address - Phone:212-288-0787
Mailing Address - Fax:
Practice Address - Street 1:525 E 86TH ST
Practice Address - Street 2:APT. 2G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7512
Practice Address - Country:US
Practice Address - Phone:212-288-0787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist